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Assurances given on generic prescribing

05 May 2017

Amid pre-Budget speculation in Parliament House and around the health sector in Canberra that the Government was considering making generic prescribing mandatory, the AMA went public with its concerns and sought clarity and certainty from the Government that its proposed Pharmaceutical Benefits Scheme changes would not interfere with the independence of doctor prescribing.

The AMA wanted confirmation that prescribing independence would be respected and preserved, that doctors could prescribe brand medications where they were the most appropriate for individual patients, and that the changes would not impose a new bureaucratic burden on busy doctors. These assurances were given by Health Minister Greg Hunt's office. The AMA will support the changes on the basis that all savings are ploughed back into health.

Doctors need to keep the control over prescribing medicines for their patients, despite any push for them to prescribe generic drugs.

The AMA says generic drugs can be a satisfactory alternative to brand name medicines, but doctors know what is best for their patients and should not be forced into prescribing anything.

Assurances have been given to the AMA that any Budget changes aimed at saving the PBS a reported $1.8 billion over five years will not mean doctors will be forced into prescribing generics.

AMA Vice President Tony Bartone explained these assurances when discussing reports of the changes on ABC Radio.

“There are occasions where the generic option isn’t a universally good option for some parts of our patient population,” Dr Bartone said.

He said the fact that generics and brand name medicines are chemically the same can cause a level of confusion that could result in some patients either not taking or delaying their medication.

“There are little nuances in this area and that’s where I’m saying that it’s not universally the best option,” Dr Bartone said.

“But as long as everyone’s on the same page and aware of what is being alternatively supplied and understanding the nuances of that, it’s a perfectly legitimate option to be offered.

“What we’re talking about is health literacy and being fully engaged and aware of the whole conversation around the issue.

“And yes, ultimately, anything that allows a more efficient system, a more efficient PBS, and allows those savings to be ploughed back in to offer newer, more novel medications which are being developed all the time… well that’s a good thing.”

Dr Bartone said the AMA’s concern was initially raised following reports suggesting the changes would be forced on doctors.

The Government would change the prescribing software used by doctors so that generic medicines were given by default.

GPs would have to opt out of the system each time they wanted to prescribe a particular brand name drug.

But Dr Bartone said the Minister had assured that changes to the system would not be mandatory.

“There was talk about this generic option being a mandatory or compulsory option. And what we responded to was that for some of our patient population, that’s not a good thing,” he said.

“And now we’ve received assurances that this is not going to mandatory. There won’t be an arduous workaround, and it will allow us to maintain our clinical independence.

“That is making sure that the medication that we choose is in our patient’s best interest and we know that our patient will be aware of it and will take it, because they’re used to taking it and there won’t be the possibility of confusion.”

Before the Budget, Mr Hunt told the ABC’s 7.30 that any savings from the changes would go back into the PBS by listing new medicines.

“Our commitment is that there will always be 100 per cent doctor control over the prescriptions that they give,” he said.

“That’s what it has been, that’s what it is and that’s what will be and that’s what it will always be under a Coalition Government.”

Dr Bartone told the same program that: “Independent clinical decision making and prescribing is something that the AMA holds very dear and very true to our hearts.”